Brodsky Eithan, Van Dijk Dina
COPD Management Program, Maccabi Healthcare Services, Jerusalem and Hashfela, Israel.
J Nurs Scholarsh. 2008;40(2):187-94. doi: 10.1111/j.1547-5069.2008.00225.x.
With the introduction of new and advanced nursing roles, the nursing profession is undergoing dynamic change. Realizing changes will be easier to accomplish if the nursing community and other healthcare professionals welcome the process. Recently the nursing staff mix in Israel has been undergoing a transformation: encouraging registered nurses to enhance their status by acquiring academic degrees and advanced professional training, and initiating the adoption of new nursing roles.
Our goal is to evaluate Israeli nurses' and physicians' attitudes to the introduction of new nursing roles and to expanding the scope of nursing practice.
Two hundred and fifteen nurses and 110 physicians from three large general hospitals and 15 community clinics filled in a questionnaire.
In general the majority of the nurses supported expansion of nursing practice, and such expansion did not cause significant opposition among physicians. However when the task affected patients' health, physicians were less willing to permit nurses to perform skills previously their responsibility alone. In addition, using multiple logistic regressions, support of the expansion of nursing practice was significantly higher among nurses in management or training positions, and among academically accredited nurses. Support for expanded roles was prominent among hospital physicians, graduates from Israeli schools of medicine, and less-tenured physicians.
We suggest that confirmation by various groups of physicians and nurses of standardized definitions of the new boundaries in the scope of nursing practice roles could successfully promote development of new roles and facilitate integration of the Israeli healthcare system into the global context of change.
Inter- and intra-professional collaboration, agreement, and understanding regarding advanced nursing practice roles and their introduction into the healthcare system might improve the relationship between healthcare professions and ultimately increase quality of care and patient satisfaction.
随着新的高级护理角色的引入，护理行业正在经历动态变革。如果护理界和其他医疗保健专业人员欢迎这一过程，实现变革将更容易完成。最近，以色列的护理人员结构正在发生转变：鼓励注册护士通过获得学术学位和高级专业培训来提升其地位，并开始采用新的护理角色。
我们的目标是评估以色列护士和医生对引入新护理角色以及扩大护理实践范围的态度。
来自三家大型综合医院和15家社区诊所的215名护士和110名医生填写了一份问卷。
总体而言，大多数护士支持扩大护理实践，这种扩大在医生中并未引起重大反对。然而，当任务影响患者健康时，医生不太愿意允许护士执行以前仅由他们负责的技能。此外，通过多元逻辑回归分析发现，管理或培训岗位的护士以及获得学术认可的护士对扩大护理实践的支持率显著更高。医院医生、以色列医学院的毕业生以及任期较短的医生对扩大角色的支持较为突出。
我们建议，由不同组别的医生和护士确认护理实践角色范围内新界限的标准化定义，可成功促进新角色的发展，并有助于将以色列医疗保健系统融入全球变革背景。
跨专业和专业内关于高级护理实践角色及其引入医疗保健系统的协作、共识和理解，可能会改善医疗保健专业之间的关系，并最终提高护理质量和患者满意度。
